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At the Gynaecological and Obstetric Emergency Department, we provide care for both gynaecological and obstetric emergencies. To do so, we have a professional team of gynaecology and obstetrics doctors. We also boast a number of anaesthetists, residents, midwives, nurses, assistants and paediatricians. We are open 24 hours a day, 7 days a week.
Our Unit is a pioneer in the treatment of sexual differentiation disorders at the paediatric age. We are also a renowned centre for paediatric renal transplants, and lead the way in Catalonia, especially in complex kidney transplants or transplants in combination with other organs.
The Cardiology Department Haemodynamics Unit diagnoses and treats diseases of the coronary artery, other parts of the heart, such as valves, and congenital defects. The majority of these procedures are carried out by inserting a catheter into the radial artery in the arm. In a few cases, it is inserted into the arteries in the leg.These procedures are used to treat acute myocardial infarctions and chronic coronary artery obstructions. They also enable intervention within the heart to change malfunctioning heart valves or repair heart defects. These procedures are also carried out on children and adults with congenital diseases.
The Vall d’Hebron Haemodynamics Unit is a centre of excellence with extensive experience in coronary procedures. It has three theatres for operations, one of which is shared with the Arrhythmia Unit. Another one is used for hybrid procedures, with simultaneous participation of specialists in haemodynamics and experts in cardiac surgery.
The unit has the technology and materials needed to carry out any kind of procedure, such as:
The unit is equipped to carry out operations with ventricular assistance and support with extracorporeal membrane oxygenation. It has been working in collaboration with the Pneumology Department for more than 35 years. They combine to treat pulmonary hypertension and to make the assessment before proceeding with lung transplants. The unit is a national benchmark in this field, which is 12% of its total work. It also collaborates with other hospitals internationally.
The haemodynamics laboratory has advanced anaesthetic and cardiac resuscitation equipment, along with transthoracic, transoesophagal and intracardiac echocardiography. It has specialists working in it for paediatric procedures and for adults with congenital diseases. This guarantees care for patients of any age.
In 2019, the Haemodynamics Unit carried out:
It was the unit carrying out the most aortic valve implants in Catalonia for the twenty-third consecutive year. Some of these procedures were done using world-leading cutting-edge optimisation techniques.
Thanks to the collaboration between specialists, more than 190 procedures are carried out on children and more than 80 on adults with congenital heart disease each year. The Cardiology Department takes part in all the structural cardiopathy programmes that need it. It also carries out hybrid procedures in surgery once a month.
Acute myocardial infarction and other acute heart diseasesThe majority of the procedures in the Haemodynamics Unit relate to ischaemic heart disease. This occurs when cholesterol plaques build up in the coronary arteries. These take the blood to the myocardium, the heart’s muscle tissue that pumps the blood around the blood stream. When the blood flow in the coronary arteries decreases, an ischaemia or acute myocardial infarction occurs. It usually causes a pain similar to pressure on the chest, known as chest angina. When the coronary artery is completely obstructed, an acute myocardial infarction occurs which causes heart cells to die. It is a serious illness and requires the artery to be opened immediately. This is usually done with a catheterisation. The patient is subsequently admitted to the Cardiology Critical Care Unit.
The Cardiology Department Haemodynamics Unit at Vall d’Hebron treats infarctions with catheterisation 24 hours a day, 365 days a year. It is one of the benchmark hospitals providing continuous care for this illness in Catalonia.
Heart valve diseaseThe majority of heart valve diseases can only be treated with cardiac surgery. When the disease is degenerative, due to age and ageing, techniques such as an aortic valve implant or a MitraClip can also be used. To decide on suitable treatment, the “heart team” intervene. This is a multi-disciplinary team, consisting of clinical, surgical, cardiology, imaging and anaesthesia experts and specialists in critical cardiac care.
Paediatric and adult congenital heart diseaseThe most frequent heart disease is congenital. Techniques to treat congenital defects via the skin often supplement reconstructive surgery. Vall d’Hebron is a worldwide benchmark for this operation on people of all ages. Paediatric treatments have been developed to adapt to children’s growth and evolution.
Pulmonary hypertension/lung transplantIncrease in pressure in the pulmonary arteries may be a secondary disorder to other cardiac or pulmonary disease, or also may be a primary problem. The treatment for this disease requires monitoring to control the pressure’s reaction to the drugs. The patient can be monitored using right heart catheterisation and using the vascular/pulmonary remodelling study with intravascular ultrasound. Patients having a lung transplant must undergo a series of cardiac tests beforehand, to ensure the success of the operation. The tests are catheterisation and coronary revascularisation. Catheterisations are also done in a situation of isometric and dynamic physical exercise to assess the heart’s response to the effort.
The Haemodynamics Unit carries out interventional diagnostic and interventional therapeutic catheterisations.
Interventional diagnostic catheterisations
The most usual is the study of the heart’s anatomy using a coronary catheterisation. The procedure consists of inserting a catheter into an artery in the forearm or leg until it reaches the coronary artery. The catheter allows the radiocontrast agent to be introduced in order to visualise the artery using radioscopy. Specific material may also be inserted to unblock the artery.
Other diagnostic procedures using a catheter are as follows:
Interventional therapeutic catheterisations
These are procedures via the skin that enable the treatment of some heart diseases and lesions without surgery.
The most common is coronary angioplasty. This consists of unblocking the coronary artery using a catheter. This is often done in the acute phase of a myocardial infarction, along with suction of the thrombosis that obstructed the artery and caused the infarction. The catheter is also used to insert a stent, a small cylindrical mesh, to completely open the coronary artery at the obstruction point.
The unit carries out other procedures, such as:
The Haemodynamics Unit takes active part in lines of research, for example:
The Haemodynamics Unit's team of professionals takes active part in academic education and practical training on the medicine and nursing degree courses. Cardiology residents usually spend time at the unit, along with residents from other Spanish, European and Latin American hospitals who are interested in training on this sub-speciality. The unit's professional team regularly takes part in training activities outside the hospital.
Each year, the unit organises a guidance course on treating coronary bifurcations with imaging techniques. It also organises a course on choosing a catheter, as a guide for coronary angioplasty. A course in the form of practical academia on the treatment of chronic occlusions is held twice a year.
The Haemodynamics Unit has a section head and six assistants. They work with the nursing team, which consists of thirteen specialist professionals. The latter work in the theatres and in the hybrid operating theatre, as and when needed.
The main purpose of the Gynaecology Department is to offer constant, up-to-date expert service to all women in our area of influence. On the other hand, as are a level three hospital, we are leaders in high-level techniques and technologies.
Our Department is one of the finest in the country, especially for oncology, for cancer of the breast and lower female genitalia. These are complex pathologies whose treatment must take a multidisciplinary approach. Thanks to the support we receive from multiple specialists, we are proud to offer a high-quality service.
Coordinating with primary care services and providing comprehensive care from the very first point of contact are both essential aspects of the service. This is necessary for women of all ages, from paediatric gynaecology, paediatric endocrinology, gynaecological pathologies, pre-invasive lesions, which can be precursors to cancer, and malignant tumours in both the genitalia and the breast, menopause and post-menopausal pathologies.
Our overall objective is to provide care for patients in our area of influence, including gynaecological care, as well as training and healthcare prevention measures and, at the same time, we aim to become a Centre of Excellence for certain pathologies, such as high-complexity surgeries.
The specific objectives of the healthcare division are, firstly, to provide medical care as urgently as possible in presumably benign pathologies. For all patients with either presumptive or confirmed diagnosis of neoplasia (abnormal formation of a new tissue, benign or malignant tumour), both gynaecological and mammary, immediate care must be provided. Finally, we must review and produce protocols and clinical guides for all the most common pathologies.
In all cases, we aim to carry out surgical treatment of gynaecological and mammary neoplasms when indicated with as short a waiting time as possible between diagnosis, histology and surgery.
Since it was constituted in 1968, the Paediatric Endocrinology Unit has consolidated the care, teaching and research it offers to make it one of the most prestigious centres both nationally and internationally, as shown by the significant number of articles published in major journals.
This Unit was created in 1968, in the first years of the Hospital, by Dr Enric Vicens-Calvet, and since then we have offered paediatric endocrinology as a specialty, actively participating in the constitution of the Spanish Society of Paediatric Endocrinology and the International Association for Child and Adolescent Diabetes. (IESGD). It is made up of:
Portfolio of services
The Paediatric Endocrinology Unit carries out significant research activity, and has a laboratory for research into growth pathologies and sexual differentiation disorders. We are also pioneers in the design and implementation of public health programmes aimed at the prevention of childhood and youth obesity (Children in Movement Programme), the treatment of morbid obesity in teens, and we are also a reference hospital in the diagnosis and treatment of congenital hypothyroidism.
Our Unit is also dedicated to teaching, and for more than 18 years, we have offered a master’s programme in paediatric endocrinology and nutrition, a postgraduate programme that has resulted in more than 180 qualified paediatricians receiving training in paediatric endocrinology. They are now heads of paediatric endocrinology units at the majority of level two and three hospitals with a Paediatrics Department in Catalonia, the rest of Spain and Latin America. All the Unit’s medical staff participate actively both in undergraduate and postgraduate education.
In addition to the subspecialties that are traditionally related to the field, the Gynaecology Department at Vall d'Hebron University Hospital has for several years now also incorporated gynaecological endoscopic surgery: laparoscopy and hysteroscopy. These account for almost 50% of the scheduled operations performed by the Department and most of them are carried out as outpatients, in the day hospital.
This Unit carries out diagnosis, treatment and monitoring of benign gynaecological pathologies that require surgical treatment using laparoscopic treatment.
The Major Outpatient Surgery Unit is located on the 3rd floor of the Maternity and Children's Hospital, next to the three operating theatres where the Endoscopy Unit and Post-Surgical Resuscitation Division carry out most of their operations.
The surgical area on the 3rd floor is home to the day hospital for major outpatient surgery, with capacity for 6-7 patients in each surgical session. Activity is divided into: four weekly surgical sessions for laparoscopy and one for hysteroscopy. The hospitalisation area is located on the 9th floor of the Maternity and Children's Hospital, with clinics on the 4th floor, where we carry out three modules per week.
At the Pere Virgili Health Park, where we have an operating room, there is a fortnightly module for low-complexity outpatient surgery. Since June 2009, we also offer the possibility of robotic assistance using the Da Vinci system, for more complex endoscopic procedures.
The Endocrine, Metabolic and Bariatric Surgery Unit is part of the General Surgery Department and has two main purposes: on the one hand, we handle tasks related to endocrine surgery, and, on the other, we also handle metabolic and bariatric issues.
We offer excellence in care for thyroid surgery, and our clinical research and the use of the latest techniques, such as recurrent nerve monitoring and visual amplification of the surgical field, mean the care provided for this pathology guarantees the highest standards, both in benign and malignant pathology.
As for parathyroid pathology, we always try to use minimally invasive techniques.
Adrenal pathology is addressed primarily through laparoscopic surgery, and the Unit has acquired extensive experience over the years.
In the fields of bariatrics and metabolism, we perform all types of technique, both restrictive and malabsorptive and mixed techniques: gold standard, laparoscopic gastric bypass and vertical laparoscopy.
The introduction of robotic surgery at the Unit means we have become pioneers in robotic bariatric surgery, with the creation of a model of robotic surgical technique for gastric bypass and tubular gastroplasty.
Surgery is a fundamental pillar for patients diagnosed with morbid obesity living with health problems such as diabetes mellitus, hypertension, cardiocirculatory problems and respiratory disorders. The objective of bariatric surgery is twofold: on the one hand, to re-educate eating habits so that the maximum loss of excess weight can be achieved in the shortest amount of time possible in a sustainable way and, on the other hand, to prevent, reduce and treat obesity-related comorbidity.
Our arsenal of surgical techniques, such as gastric bypass and vertical gastrectomy, includes more complex techniques to alleviate the devastating effects of obesity on such patients. Likewise, in the last 15 years, developments in robotic surgery (where the surgeon operates on the patient through the use of a robot that responds to their orders, improving precision, vision and possibilities of movement) mean these techniques can be carried out more safely and have become more commonplace.
Vall d'Hebron University Hospital is a European reference centre in robotic surgery for obesity. In 2012, we were the first hospital in Spain to operate on the first adolescent patients with morbid obesity, and we are currently recognised as a centre of European excellence.
The joint work of bariatric surgeons and endocrinologists means the Unit is in a privileged position when it comes to metabolic surgery to treat diabetes, when appropriate.
The Section carries out its own research projects, collaborating with other hospitals and other Departments within our Hospital, further information about which can be found in the publications and research sections.
For teaching, our Section has two resident doctors who rotate periodically. We also train medical students from the Autonomous University of Barcelona in the surgical disciplines related to our Unit.
The Digestive Surgery and Transplant Department depends on the Paediatric Surgery Department and has pursued lines of work in the treatment of Hirschsprung's disease, anorectal malformations and treatment of short gut syndrome, and, in this last field, it is one of the most experienced centres in Spain in the "step" technique, among others.
Our Department stands out for our use of endoscopic and laparoscopic techniques, including robotic techniques, and for our treatment of complex hepatobiliary pathologies, with excellent results in the obstruction of bile ducts, hepatic resections and the surgical treatment of portal hypertension with all kinds of shunt techniques, including "Rex shunts". The Unit is also a leader within Spain for the treatment of congenital portocaval shunts.
The Cabinet of Digestive Physiology is a leading name in the study of gastroesophageal reflux (pH-metrics and bioimpedimetry) and anorectal manometry.
We cannot think of children as miniature adults, their bodies are growing and developing until they point they reach skeletal maturity. Medical professionals treating diseases of and injuries to the bones, joints and muscles of children must be experts in the specific nature of said diseases and injuries. Paediatric Orthopaedic Surgery is the subspecialty that is deals with these problems in children.
Between childhood and adolescence, there are many varied osteoarticular processes that children may experience. If we look at age, it is obvious that the issues faced by babies vary greatly from those faced by adolescents. So, while congenital abnormalities and postural deformities are most common in babies, young children present more disorders in gait and deformities of the limbs. Later on, when the children are older, several pathologies of the hip and spine can appear. Once a child reaches adolescence, fractures are the most common issue. The origin of the different problems is also very diverse, and can include infectious or tumoural congenital processes.
Many paediatric diseases manifest with skeletal deformities or disorders of function, which is why paediatric orthopaedic specialists must work in coordination with the other Paediatrics specialists: neonatologists, neurologists, nephrologists, endocrinologists, rheumatologists, pneumologists, oncologists and gastroenterologists. In turn, they need the collaboration of other specialists such as radiologists, anaesthetists, rehabilitators and pathologists.
The Paediatric Orthopaedic Surgery Unit of our hospital is accredited as a centre of reference for the various pathologies covered by our specialty, as well as neurodegenerative diseases (childhood cerebral palsy, spina bifida, neuromuscular diseases, peripheral neuropathies) bone dysplasia (achondroplasia, imperfect osteogenesis) and major bone deformities (stretching and bone corrections). We also collaborate with other departments and units in other pathologies that are also considered reference centres in our hospital: such as the CSUR in childhood sarcomas.
The members of the Unit are fully qualified and trained to perform non-surgical and orthopaedic treatments that cover the subspecialty of Paediatric Orthopaedic Surgery.
The Unit is located at the Vall d’Hebron Maternity and Children's Hospital and falls under the Orthopaedic Surgery and Traumatology Department.
The Paediatric Orthopaedic Unit has five lines of research underway:
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